Gretchen Jackson
Individual provider Active NPI Developmental Therapist · Glenwood, IL
NPI 1336067321 · NPPES record last updated Jul 7, 2026
Key facts
- NPI
- 1336067321
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 120 S Rebecca St
Glenwood, IL 60425-1622 - Phone
- (708) 655-1932
- NPI assigned
- Jul 7, 2026
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
120 S Rebecca St
Glenwood, IL 60425-1622
Mailing address
120 S Rebecca St
Glenwood, IL 60425-1622
Phone (708) 655-1932
Other providers in Glenwood, IL
- Health Providers
- Kayla Henry
- Vivian Diane Hudson-Davis
- Inspire Greatness Within, Inc.
- Ontonio Jackson-Lucas
- Jencare Neighborhood Medical Center Glenwood, LLC
- Leah Renee Jones
- Journeys of You
- Ashley Kendrick
- Kierra Langston
All providers in Glenwood, IL · Developmental Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.